• Article
  • November 7, 2018

3 Solutions to Common Challenges Facing Children's Hospital Leaders

Learn about solutions three hospitals created to tackle common, yet complex issues.

Children's hospital leaders have an increasing sense of urgency to address needs of patients and the people who care for them. Challenges today's leaders face include onboarding and retaining millennial health care workers, managing costs related to length of stay (LOS) and keeping physician leadership skills honed while maintaining their resiliency.

At CHA's 2018 Annual Leadership Conference, presenters shared information to help attendees build a more resilient workforce, improve leadership skills and promote better care for kids. Here's a sneak peek at three sessions that cover some of the biggest issues leaders are encountering today.

Retaining millennial nurses

While the new millennial nurse is excited about starting a career in health care, data shows gaps in the onboarding and retention plans for this group. When the NICU and PICU experienced rising turnover rates at Children's of Mississippi, leaders looked into creative ways to address the professional and personal goals of novice millennial nurses. The team used published methodology and nursing theory to develop Rainbow Road, a color-coding tool to identify the characteristics of these nurses and their experiences. Rainbow Road aims to simplify the complexities of role transition and reverse high turnover rates.

At the conference, the hospital detailed how from 2015 to 2017, Rainbow Road helped reduce NICU turnover by 55 percent with a cost savings of $2 million. The PICU experienced stabilization in turnover during the same period even though the unit was in the midst of significant leadership changes. Lessons learned from Rainbow Road include:

  • Not all turnover is bad, so use data to drive improvement
  • Reverse the effect of millennial turnover by using target actions to meet their needs
  • Create culture change by removing silos
  • Millennial nurses need to know that leadership cares about them and will listen
  • Planning for meetings and classes on Rainbow Road takes more time than expected

Physician resiliency and leadership development

Something as simple as adapting to physicians' schedules and the demands of their jobs helped Ann & Robert H. Lurie's Children's Hospital of Chicago develop a successful coaching program to boost the leadership skills of emerging clinical leaders. Lurie Children's tried a new approach: more than 85 of the hospital's physicians have received internal, executive coaching, while more than 40 physicians receive ongoing coaching.

Coaching sessions are tailored to each physician and flexes with their needs. In this model, the coach conducts several follow-ups to support performance. The program is widely accepted, in part, because leaders position it as a perk or investment in the individual, not as a way to target problematic behavior or a personal evaluation. Satisfaction numbers are high—for the last five years, 100 percent of survey participants give positive or enthusiastic feedback about the program.

Quick diagnosis improves outcomes

Speeding up the identification of genetic illnesses in infants can drastically improve outcomes, produce cost savings and increase family satisfaction. Rady Children's Hospital San Diego started using rapid whole genome sequencing (rWGS) in the NICU to quickly diagnose infants and identify specific genetic illnesses so providers could start necessary treatment plans sooner. In their conference presentation, Rady Children's will describe the rWGS program used for critically ill patients in the NICU and PICU. This group saw dramatic changes in clinical treatments and outcomes within the first year of the program.

Using rWGS may sound expensive and not cost effective. But Rady Children's reports that care using rWGS compared to a control group was significantly less expensive because of shorter LOS and lower use of resources.

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